Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2022; 10(14): 4550-4562
Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4550
Periodontal-orthodontic interdisciplinary management of a “periodontally hopeless” maxillary central incisor with severe mobility: A case report and review of literature
Ke Jiang, Li-Shan Jiang, Hou-Xuan Li, Lang Lei
Ke Jiang, Lang Lei, Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
Li-Shan Jiang, Hou-Xuan Li, Department of Periodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
Author contributions: Jiang K collected the medical records and mainly drafted the manuscript; Jiang LS partly drafted the manuscript; Li HX and Lei L revised the manuscript critically for important intellectual content; all authors have read and approved the final version of the manuscript.
Informed consent statement: Informed consent was obtained from the patient for the publication of this case report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revisedaccording to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Lang Lei, PhD, Associate Professor, Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, No. 30 Central Road, Nanjing 210008, Jiangsu Province, China.
Received: September 21, 2021
Peer-review started: September 21, 2021
First decision: October 22, 2021
Revised: November 3, 2021
Accepted: March 25, 2021
Article in press: March 25, 2021
Published online: May 16, 2022

Treating periodontally hopeless teeth with advanced bone resorption and severe tooth mobility is a great challenge for both orthodontists and periodontists. Biofilm-induced periodontal inflammation and occlusal trauma-related inflammation may synergistically aggravate tooth mobility. This case report illustrates that even periodontally hopeless teeth can be saved and have long-term stability with comprehensive periodontal treatment to control periodontal inflammation and promote periodontal bone regeneration and intricate orthodontic mechanical control to correct cross bite and occlusal trauma.


A 27-year-old female patient whose chief complaint was severe tooth mobility and discomfort of the maxillary incisor was diagnosed with severe aggressive periodontitis by clinical and radiographic examinations. To reduce tooth mobility and establish stable occlusion, we combined orthodontic treatment with periodontal therapy to preserve the tooth. Orthodontic treatment was performed after basic periodontal therapy and periodontal surgery. The loosened upper right central incisor was successfully retained, and the periodontal tissue remained stable during follow-up.


Teeth with severe mobility and bone loss can be saved through interdisciplinary treatment when periodontal inflammation is strictly controlled.

Keywords: Occlusal trauma, Periodontally hopeless teeth, Periodontitis, Orthodontics, Guided tissue regeneration, Interdisciplinary management, Case report

Core Tip: Traditionally severe tooth mobility may affect the prognosis after orthodontic tooth movement, since orthodontic treatment has been reported to increase tooth mobility. However, whether orthodontic tooth movement can be conducted in “periodontally hopeless teeth” with Class III mobility has never been reported. In this case report, we described periodontal-orthodontic interdisciplinary treatment of a case with a “periodontally hopeless” upper central incisor with Class III mobility.